In order to evaluate the nature and frequency of adverse reactions associated with Therapeutic Apheresis (TA), database information from two large mobile apheresis services was analyzed. A total of 17,940 procedures performed on 3,583 patients were studied using an Access Database. Seventy percent (12,558) of the procedures were performed on a Fresenius AS104 blood cell separator and 30% (5,382) were performed on a COBE Spectra. The five most commonly treated diseases were Guillain-Barre Syndrome (25%), thrombotic thrombocytopenic purpura (20%), myasthenia gravis (18%), the hyperviscosity syndrome (12%), and chronic inflammatory demyelinating polyneuropathy (9%). All patients received calcium gluconate supplement during the procedures. Cardiac monitoring was used during 80% of the procedures and blood pressure monitoring was used during all procedures. All procedures were supervised by a physician. Both apheresis services fully comply with the ASFA Guidelines for Therapeutic Apheresis Providers. Adverse reactions occurred in 3.9% of all procedures. The following adverse reactions were documented: reactions related to ACD toxicity (3%), vasovagal reactions (0.5%), vascular access related complications (0.15%), reactions related to FFP (0.12%), hepatitis B from FFP (0.06%), arrhythmias (0.01%), hemolysis due to inappropriate dilution of 25% albumin (0.01%), and one death (from underlying disease) during a TA procedure (0.006%). These data demonstrate that therapeutic apheresis is associated with a low rate of side effects when performed by well-trained and certified nurses under the direction of experienced physicians, even in the diverse setting of large mobile therapeutic apheresis programs.

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Patient safety during therapeutic apheresis involves both practitioners' and institutional provision of care aspects. Physician training experiences, medical licensing, and board certification status, along with continuing medical education and participation in risk management/patient safety projects are characteristic facets of physician competency in the provision of quality apheresis medicine interventions. Documentation of such indicators may help in medical staff deliberations regarding physician privileging in the oversight and management of apheresis medicine activities in hospitals.

This article reports findings from a laboratory study designed to investigate self-identification among 69 multiracial and multiethnic women. Respondent reactions to two current question naire formats for collecting racial information and a third version that includes a multiracial response option were examined. Findings suggest that respondents' racial identification varies considerably across question formats and that persons of mixed heritage prefer a racial identification question that provides them, at a minimum, with the opportunity to acknowledge their multiracial background. In addition, many respondents also expressed the desire to identify each of the specific groups that constitute their racial/ethnic background.

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